The Basics of What You Need to Know: Commonly Used Medicaid Terms, Coverage and Eligibility and the Difference Between Medicaid and Medicare
On Tuesday, November 13, 2018,at 2 pm, join CSH and Foothold Technology for a free webinar, Medicaid and Supportive Housing 101. The webinar will cover topics ranging from commonly used terms, coverage and eligibility and the differences between Medicaid and Medicare. This webinar is designed for beginners and experts alike. Click here to register for the webinar.
- Sue Augustus with CSH,
- Foothold Technology Director of Client Services, Paul Rossi, and
- Senior Advisor, David Bucciferro, will present on the webinar.
Medicaid is a health insurance entitlement program, meaning that it will pay for certain health care-related services for those who are eligible and enrolled in Medicaid. it was established as part of the Social Security Act of 1965.
- The federal government and state governments share responsibility over Medicaid.
- At the federal level, guidance, regulatory and funding responsibilities for Medicaid are managed by the Centers for Medicare and Medicaid Services (CMS). At the state level, states administer the program within federal guidelines and law.
- Governors designate a single state agency to administer the program; typically, this is a health and human services department.
The cost of the program is shared between the federal and state governments. States are required to pay for allowable services, provided by approved providers. States receive matching payments from the federal government for allowable costs of the state’s program. The matching rate typically ranges between 50 and 75% depending on a number of factors.
- Federal law defines mandatory and optional services and eligibility criteria.
- States then have the ability to tailor Medicaid to meet their state’s needs by selecting various authorities (such as optional services or waivers) to modify who is eligible, what services are available, and the level of services allowed, and who can provide these services.
- States can restrict eligibility to non-mandatory services so that individuals eligible for Medicaid may not be eligible for all services offered in a state.
- A state’s tailoring of Medicaid is documented in a state’s Medicaid plan.
- Medicaid expansion was signed into law in 2010. It has increased the number of people eligible for Medicaid.
- While the Supreme Court determined that states are not required to expand their Medicaid coverage, most states including New Jersey have expanded.
- Gov. Chris Christie (R) on June 28, 2013, signed a state budget that includes $227 million for Medicaid expansion in the state.
- According to New Jersey Policy Perspective (NJPP), 528,000 people in New Jersey gained coverage as the result of the Medicaid expansion. Christie vetoed legislation that would have made the expansion permanent in the state.
- Most people living in supportive housing are eligible for Medicaid based on a disabling condition (either physical or mental) so public and private options are still available for modifying Medicaid, regardless of expansion.